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Hic-5/ARA55 inhibits the growth of Lovo cells by up-regulating the expression of P27.

Ying-chao WU ; Xin WANG ; Yu-cun LIU ; Yuan-lian WAN ; Jing ZHU

Chinese Journal of Surgery.2008;46(11):843-846.

OBJECTIVETo investigate the effects of Hic-5/ARA55 on the growth of the human colorectal cancer cells (Lovo cells) and its mechanism.

METHODFlow cytometry (FCM) was used to study the cell cycle of Lovo cells (Lovo group), Lovo cells stably transfected with empty vector (Lovo-Vector group) and the Lovo cells stably transfected with vector containing Hic-5/ARA55 (Lovo-Hic-5/ARA55 group). Western blot assay was used to detect the principal cyclins in the three groups, and Luciferase assay was used to study the mechanism between Hic-5/ARA55 and the only target cyclin. The cells from the three groups were inoculated subcutaneously into 7 nude mice (Balb/c nu/nu) respectively to observe the effects of Hic-5/ARA55 on the growth of the cells in vivo. Seven weeks later, the subcutaneous tumors were harvested and weighed. Then immunohistochemistry assay was used to detect Hic-5/ARA55 and the target cyclin in the tumors.

RESULTSThe cell cycle was obviously delayed from G0/G1 to S stage in Lovo-Hic-5/ARA55 cells. A significantly higher expression of P27 was found in Lovo-Hic-5/ARA55 cells than in the other two groups. The weight of the subcutaneous tumors of Lovo-Hic-5/ARA55 cells, Lovo cells and Lovo-Vector cells were (0.33 +/- 0.23) g, (1.20 +/- 0.39) g and (1.30 +/- 0.49) g, respectively; the tumors of Lovo-Hic-5/ARA55 cells was significantly lighter than those of the other two groups (P<0.05). Hic-5/ARA55 and P27 were both over-expressed in implanted tumors of Lovo-Hic-5/ARA55 cells, while were both expressed lower or not expressed in the other two groups. And the expressions of Hic-5/ARA55 and P27 were highly positive correlated (r=0.816, P<0.05).

CONCLUSIONHic-5/ARA55 could inhibit the growth of Lovo cells both in vitro and in vivo by up-regulating the transcription of P27.

Animals ; Cell Cycle ; Cell Line, Tumor ; Colorectal Neoplasms ; genetics ; metabolism ; pathology ; Cyclin-Dependent Kinase Inhibitor p27 ; metabolism ; Gene Expression Regulation, Neoplastic ; Genetic Vectors ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; metabolism ; Male ; Mice ; Mice, Nude ; Plasmids ; genetics ; RNA, Messenger ; genetics ; Transfection ; Xenograft Model Antitumor Assays

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Determination of the postoperative effect on intestinal structure and myoelectric motility in rabbits: modified uncut jejunal loop versus Roux-en-Y biliodigestive anastomosis.

Li HUANG ; Li-jian LIANG ; Jia-ming LAI

Chinese Journal of Surgery.2008;46(11):839-842.

OBJECTIVETo evaluate influences on intestinal structure and myoelectric motility between modified uncut jejunal loop and Roux-en-Y procedures for biliodigestive anastomosis.

METHODSFifteen rabbits were randomized in modified uncut jejunal loop group, Roux-en-Y group and control group. Traced fasting slow-wave frequency (SWF) before biliodigestive diversion and 25 d postoperative (POD25) during laparotomy. Before the second laparotomy on POD21, the fasting SWF, percentage of abroad migrating myoelectric complex (MMC%), the postprandial spike potential frequency (SPF) and percentage of abroad propagation (SP%) were recorded in vivo. Compared myoelectric recordings according to parameters above. On POD90, harvested the stitched ligation of ascending loop and part of descending loop in uncut group, and biliary limb in R-Y animals, which assessed under HE, c-kit labeling immunohistochemical staining and transmission electron microscope(TEM).

RESULTSOn POD25, SWF declined mildly in uncut group (8.4%) and markedly in R-Y group (23.8%) respectively. The difference was significant (P<0.05). Before laparotomy on POD21 when abdomen closed, between uncut and control animals, there were statistical difference in fasting SWF and postprandial SPF (P<0.05), while no significance in MMC% and SP% (P>0.05). Moreover, differences of each parameters between R-Y group and control or uncut group were markedly statistical (P<0.01). Abroad myoelectric propagation through the ligated segment can be observed in uncut animals. Meanwhile, ectopic pacemaker was detected locating in the proximal segment of the Roux limb and triggering retrograde propagation in R-Y animals. On POD90, no recanalization were observed In uncut animals. Furthermore, occluded lumen with mild atrophic mucosa under microscope and c-kit labeling cells located in the inner circular muscle layer were observed, which proven to be Interstitial cells of Cajal (ICCs) by TEM. In R-Y animals, lumen of the Roux limb dilated. There's no significant difference in c-kit labeling area between R-Y and uncut animals by image analysis system. Reductions of processes and intercellular gap junction in ICCs, and loose interconnections between ICCs and SMCS or nerve endings were observed in R-Y animals.

CONCLUSIONSImpaired gastrointestinal motility after the Roux-en-Y procedure may due to the aberrant interstitial cells of Cajal. Modified uncut technique reveals a reliable and effective alternative for biliodigestive reconstruction.

Anastomosis, Roux-en-Y ; Animals ; Electrophysiology ; Female ; Intestines ; metabolism ; physiology ; surgery ; ultrastructure ; Jejunostomy ; methods ; Peristalsis ; physiology ; Postoperative Period ; Proto-Oncogene Proteins c-kit ; metabolism ; Rabbits ; Random Allocation

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A model of lumbar disc degeneration on the early stage in rhesus monkey with minimally invasive technique.

Jie KONG ; Zi-xuan WANG ; Ai-yu JI ; De-chun WANG ; Zong-hua QI ; Wen-jian XU ; Da-peng HAO ; Feng DUAN ; You-gu HU

Chinese Journal of Surgery.2008;46(11):835-838.

OBJECTIVETo establish a novel model of lumbar disc degeneration on the early stage in the rhesus monkey using percutaneous needle puncture guided by CT.

METHODS(1) Thirteen rhesus monkeys aged from 4 to 7 years, female 7 and male 6 were selected for establishing a model of the early stage of lumbar disc degeneration. (2)13 monkeys, 91 discs were divided into 3 groups: 64 discs from L1/2 to L5/6 were percutaneous punctured with a needle 20G as experimental group and 1 disc with a needle 15G as puncture control group and 26 discs were not be punctured from L6,7 to L7-S1 as control group. (3) Lumbar disc localization for needle puncture was guided by CT. All discs were examined by MRI, the HE, Masson's trichrome, Safranine-O and immunohistochemical staining of type II collagen before disc puncture and after puncture at 4, 8 and 12 weeks.

RESULTSMRI: (1) Experimental group: Pfirmann's Grade I was shown at postoperation 4, 8 and 12 weeks; (2) Puncture control group: Grade III was shown at postoperation 4 weeks and Grade IV at 8 weeks; (3) CONTROL GROUP: Grade I was shown at postoperation 4, 8 and 12 weeks. Histological examination: (1) In experimental group, there was no any change at postoperation 4 weeks, and the cell population of the nucleus was decreased at 8 weeks and more decreased at 12 weeks in HE. (2) There was no any change at postoperation 4 weeks, the clefts among the lamellae of the annulus fibrosus (AF) were shown at 8 weeks and more wider of the clefts of AF at 12 weeks in Masson's trichrome. (3) No any change was shown at postoperation 4 weeks, proteoglycan were progressively decreased at 8 and 12 weeks in Safranine-O. (4) No statistically significant difference in positive rate was observed at 4 and 8 weeks compared with control group in immunohistochemical staining of type II collagen. There was statistical difference at 12 weeks compared with control group (P<0.05). In puncture control group postoperation 8 weeks, the morphology of cell of nucleus pulposus was not clear in HE. The wider clefts of lamellae of the AF were shown in Masson's trichrome. The proteoglycan was obviously decreased in Safranine-O. Immunohistochemical staining collagen II synthesized was decreased. In normal control group, no any change was shown at 4, 8 and 12 weeks.

CONCLUSIONSThe degeneration of lumbar intervertebral disc on the early stage could be induced by the percutaneous needle puncture (20G) to the annulus fibrosus. The assessment of disc degeneration on early stage is not shown on MRI and only confirmed by histological examination.

Animals ; Disease Models, Animal ; Female ; Intervertebral Disc ; metabolism ; pathology ; surgery ; Intervertebral Disc Displacement ; etiology ; metabolism ; pathology ; Lumbar Vertebrae ; surgery ; Macaca mulatta ; Male ; Minimally Invasive Surgical Procedures ; Random Allocation

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Clinical research about treatment for adrenal incidentalomas.

Xian-kui LIU ; Xian-jie LIU ; Xiao DONG ; Chui-ze KONG

Chinese Journal of Surgery.2008;46(11):832-834.

OBJECTIVETo explore the therapeutic methods of adrenal incidentalomas.

METHODSThe data of 156 cases were analyzed retrospectively.

RESULTSThe operation were performed in 151 cases, radiotherapy and chemotherapy in 1 case and follow up in 4 cases. The diameter of the tumors were 1.3-15.0 cm. Pathological results indicated that 34 cases were pheochromocytoma, 83 adrenal cortical adenoma, 5 adrenal cortical carcinoma, 3 metastases carcinoma, and 26 other benign tumors. One hundred and thirty-six cases were followed-up for 1-7 years. 3 cases of metastases carcinoma died in 1.5 years, 2 cases of cortical carcinoma died in 2.0 and 2.5 years for recurrence and metastases. One hundred and thirty-one cases survived healthy, 3 cases of them take orally dexamethasone for 1 year after post-operation.

CONCLUSIONSSurgical operations should be performed in malignant tumors, hypersecretion tumors, deuto-clinical adrenal cortical tumors, pheochromocytoma and those whose diameters of tumors are over 3 cm. But those whose tumors had non-hypersecretion and diameters are less than 3 cm should be followed up closely.

Adolescent ; Adrenal Gland Neoplasms ; pathology ; surgery ; Adrenalectomy ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies

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Clinical analysis of renal cell carcinoma: report of 271 cases.

Fu-fu ZHENG ; Yu-ping DAI ; Dao-sheng LUO ; Yue-you LIANG ; Chun-hua DENG ; Wei CHEN ; Ling-wu CHEN ; Xiao-fei LI ; Shao-peng QIU ; Ke-li ZHENG

Chinese Journal of Surgery.2008;46(11):829-831.

OBJECTIVETo study the diagnosis and treatment of renal cell carcinoma.

METHODFrom January 1993 to December 2000 the data of 271 cases of renal cell carcinoma were reviewed.

RESULTSUltrasonography and CT scanning were still the main diagnostic methods. Surgical operation was performed on 234 patients. Radical nephrectomy was performed on 197 patients (72.6%); Nephron sparing surgery was performed on 19 patients; Metastatic tumor resection was performed on 6 patients and other procedures for 12. The pathological results showed that 137 cases (61.4%) were clear cell carcinoma, 18 cases (8. 1%) of granular cell carcinoma, 32 cases (14. 3%) being combination of the above two varieties, 23 cases (10.3%) of renal papillary adenocarcinoma, 13 cases being renal cell of other types. And 210 cases (77.5%) had been successfully followed up. The 1, 3, 5 and 10 year survival rates were 95.3% (182/191), 88.7% (107/122), 74.7% (56/75) and 32.1% (10/31) respectively.

CONCLUSIONSUltrasonography is the first select examination method of detecting of renal cell carcinoma, and CT scanning is the most valuable diagnostic mean. Early diagnosis and prompt radical nephrectomy or nephron sparing nephrectomy are the critical points for achieving long-term survivals of patients with renal cell carcinoma.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Renal Cell ; diagnosis ; surgery ; Child ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; diagnosis ; surgery ; Male ; Middle Aged ; Nephrectomy ; methods ; Nephrons ; surgery ; Prognosis ; Retrospective Studies

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The clinical analysis of 51 patients with thoracic aortic dissection.

Zhi-yong WU ; Zhi-wei WANG ; Zhi-fu MAO ; Shi-qian LU ; Jun XIA ; Liang-ru DING

Chinese Journal of Surgery.2008;46(11):826-828.

OBJECTIVETo summarize the clinical experience about surgical treatment of aortic dissection.

METHODSThe clinical data of 51 patients with aortic dissection admitted from December 2004 to December 2006 were analyzed retrospectively. There were 35 male and 16 female patients with a mean age of 55.7 years (ranged from 18 to 83-years-old). Twenty-seven patients of type I was performed under deep hypothermic circulatory arrest and selected cerebral perfusion with stent-graft which was implanted into the descending aorta through aorta arch. Five patients of type II was performed including Bentall operation in 3 patients, Wheat operation in 1 patient, ascending aorta replacement in 1 patient. Nineteen patients of type III was performed with stent-graft which was implanted into the descending aorta through aorta arch under deep hypothermic circulatory arrest.

RESULTSThe time of cardiopulmonary bypass (CPB) in type I patients was 250 to 290 min with an average of (274 +/- 53) min, and the arrest time was 40 to 59 min with an average of (53 +/- 14) min. CPB time of type II patients was 130 to 159 min with an average of (146 +/- 43) min, and the cross clamp time was 60 to 79 min with an average of (66 +/- 15) min. CPB time of type III patients was 240 to 280 min with an average of (260 +/- 28) min, and the arrest time was 20 to 27 min with an average of (24 +/- 3) min. The mean hemorrhage volume of the entire group was (500 +/- 250) ml. The mean ICU retention time was (5.0 +/- 1.5) d and the length of stay was (15.0 +/- 2.5) d. Three patients died during perioperative period. Two patients appeared cerebrovascular accident after operation. One patient appeared descending aorta dilation in the follow-up of 2 to 21 months.

CONCLUSIONDifferent clinical manifestations and treatment should be selected according to the different condition of aortic dissection aneurysm.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aneurysm, Dissecting ; surgery ; Aorta, Thoracic ; surgery ; Aortic Aneurysm, Thoracic ; surgery ; Blood Vessel Prosthesis Implantation ; Female ; Humans ; Male ; Middle Aged ; Stents

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Analysis of surgical treatment for Standford type A aortic dissection.

Xiao-fu DAI ; Liang-wan CHEN ; Dao-zhong CHEN ; Feng LIN ; Qi-min WANG ; Zhong-yao HUANG ; Han-fan QIU ; Hua CAO

Chinese Journal of Surgery.2008;46(11):823-825.

OBJECTIVETo summarize the surgical experience of type A aortic dissection.

METHODSFrom January 2001 to December 2006, 54 cases were admitted for Standford type A aortic dissection, including 36 cases of acute aortic dissection and 18 cases of chronic. Thirty-five cases underwent emergence operation and 11 cases underwent selective/limited operation, while 8 cases received medical treatment According to the modus operandi of root of aorta, 9 cases underwent ascending aorta replacement merely, 11 cases for Bentall operation, 12 cases for Wheat operation and ascending aorta replacement, 14 cases for David operation and ascending aorta replacement. According to the modus operandi of aortic arch and descendens, 6 cases underwent right hemiarch replacement, 25 cases for total arch replacement with four branches aortic graft, 24 cases for stent-graft elephant trunk technique. One patient of coronary heart disease and 1 patient of right coronary fracture underwent coronary artery bypass grafting. Deep hyperthermic circulatory arrest and antegrade selective cerebral perfusion were applied with aortic arch operation. Surface cooling was applied with selective/limited operation.

RESULTSFour patients died in operation group (8.7%) and 8 died in non-operation group (75.0%). Postoperative complication included 1 mental symptom, 3 pleural/pericardial effusion, 1 hoarseness, 1 sternal rupture and poor wound healing. All the complication were cured. The operative out-hospital patients were followed up (13.0 +/- 14.2) months and the quality of life was satisfied.

CONCLUSIONSStandford type A aortic dissection should be operated aggressively. Expected outcome could be acquired with optimum modus operandi, proper cerebral protection and dealing with postoperative complication timely.

Adult ; Aged ; Aged, 80 and over ; Aneurysm, Dissecting ; surgery ; Aorta ; surgery ; Aortic Aneurysm ; surgery ; Blood Vessel Prosthesis Implantation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents

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Individual immunosuppressive regime in heart transplantation with high risk.

Xi-jie WU ; Liang-wan CHEN ; Dao-zhong CHEN ; Xue-shan HUANG ; Hua CAO

Chinese Journal of Surgery.2008;46(11):820-822.

OBJECTIVETo Summarize the clinical experience of individual immunosuppressive regime in heart transplantation with high risk.

METHODSFrom September 2001 to December 2006, 51 cases with the complication of Hepatitis B viruses (HBV) infection, diabetes mellitus, renal dysfunction or pulmonary infection in perioperative period were analyzed retrospectively. All cases received daclizumab (Zenapax) induction therapy, and baseline triple immunosuppressive regime was consist of cyclosporine (CsA), azathioprine (Aza) or mycophenolate mofetil (MMF) and prednisone (Pred). Ten cases received HBV infection in preoperative period, the immunosuppressive protocol was emphasized on the use of MMF and the withdraw of Pred one month later in postoperation. Nine cases received diabetes mellitus in pre-operation, 4 cases had post-transplant diabetes mellitus. The immunosuppressive protocol was emphasized on the use of CsA rather than FK506, the use of Pred was less dosage, and the therapy of insulin was necessary. Sixteen cases had renal dysfunction in pre-operation, the use of MMF was routine but the use of CsA was delayed to the time 5 to 19 d postoperative. Twelve cases received pulmonary infection after allograft transplantation. The immunosuppressive agent was to be taped or suspended in therapy time.

RESULTSThe liver function of the 10 cases with HBV infection was stable in 1 year follow-up, and 1 case received acute rejection after 13 months allograft transplantation. In the 6 months follow-up, the blood glucose level of the 13 cases with diabetes mellitus was stable, none of the cases suffered from acute rejection. In the one month follow-up, none of the 16 cases with renal dysfunction suffered from acute rejection, and the renal function was normal. Two of the 12 cases with the pulmonary infection were died of serious infection, others were survival. One case received acute rejection on the 17th day in postoperation.

CONCLUSIONSLow mortality can be realized by selecting appropriately individual immunosuppressive regime and the episode of acute rejection is rare.

Adult ; Female ; Follow-Up Studies ; Graft Rejection ; prevention & control ; Heart Transplantation ; Humans ; Immunosuppressive Agents ; administration & dosage ; therapeutic use ; Male ; Perioperative Care ; Retrospective Studies ; Risk Factors

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Experience in the management of acute superior mesenteric artery ischemia.

Lei WANG ; Shi-jie XIN ; Jian ZHANG ; Xi-tong ZHANG ; Dong YANG ; Zan-song ZHANG ; Zhi-quan DUAN

Chinese Journal of Surgery.2008;46(11):816-819.

OBJECTIVETo study the management of acute superior mesenteric artery (SMA) ischemia and to improve its prognosis.

METHODThe clinical data of 37 patients treated from January 1996 to August 2007 was retrospectively reviewed.

RESULTSOf the cases, 19 (51.4%) patients were diagnosed with acute SMA embolism, 15 (40.5%) with acute SMA thrombosis, 2 (5.4%) with spontaneous isolated dissection of SMA and 1 (2.7%) with SMA aneurysm. Nineteen (51.4%) patients were misdiagnosed in emergency. Eighteen (48.6%) patients died in the hospital, and most of them died of severe infection and multiple organ failure. Three cases of the survived 19 patients experienced severe complications (2 with short gut syndrome, 1 with cerebral hemorrhage). Nine cases were followed-up for a mean period of 15 months, and 5 died during that term.

CONCLUSIONSAcute SMA ischemia has multiple etiological factors. Early intervention can improve the prognosis.

Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Mesenteric Artery, Superior ; Mesenteric Vascular Occlusion ; diagnosis ; therapy ; Middle Aged ; Prognosis ; Retrospective Studies

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The long-term evaluation of treatment for the lumbar disc herniation with the modified Love operation.

Nan LI ; Wei TIAN ; Gui-lin ZHANG ; Bo LIU ; Qin LI ; Zhi-yu LI ; Da HE

Chinese Journal of Surgery.2008;46(11):813-815.

OBJECTIVETo explore the long-term outcome of lumbar disc herniation (LDH) after the treatment with modified mini-invasive Love operation.

METHODSFrom January 1995 to December 2000, 373 patients suffered from LDH underwent the modified mini-invasive Love operation. There were 250 male and 123 female patients aged from 11 to 77-years-old (with a mean of 45.0-years-old). Most patients complained of sciatica accompanying back pain. The lesion level included L3,4 in 11 patients, L4,5 in 159 patients, L5-S1 in 195 patients and L4,5 combined with L5-S1 in 8 patients.

RESULTSThe average operative duration was 65 min. The average blood lose was 22 ml. The average incision length was 3.2 cm. Till September 2005, 317 patients were available at the final follow-up during the period from 5 years and a half to 10 years and 5 months. The average duration of follow-up was 7 years and 8 months. A total of 135 patients underwent the CT discogram. According to the modified Roland-Morris Dysfunction Questionnaire, 198 patients were rated as excellent, 68 as good, and 51 as fair. The excellent rate was 84.0%. The scores for young patients were higher than senile patients. Herniation recurrence occurred in 10 patients (3.2%), in which 7 patients underwent the operation of internal fixation and 1 patient preferred the conservative treatment. One patient got the spondylolisthesis.

CONCLUSIONSThe long-term outcome of the modified mini-invasive Love operation is effective. It is a good choice for the LDH patients.

Adolescent ; Adult ; Aged ; Child ; Diskectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; Male ; Microsurgery ; Middle Aged ; Retrospective Studies ; Treatment Outcome

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